EMS One-Stop

In this edition of EMS One-Stop, Rob Lawrence is joined by Bob Davies and Hilary Gates to explore the mission behind Six Minutes to Live, a growing movement focused on improving survival from sudden cardiac arrest. | MORE: ‘Six Minutes to Live': Mini-documentary spotlights cardiac arrest care crisis The conversation begins with the stark reality that every minute without CPR and defibrillation reduces survival by 10%, and then widens into a larger discussion about injustice, geography and system performance. Bob reflects on his landmark USA Today investigation into EMS disparities across the country, while Hilary explains why this issue remains deeply personal and why communities, not just medical systems, must be part of the solution. The episode then turns from problem to action. Hilary and Bob describe how Six Minutes to Live is using storytelling, advocacy, community partnerships and public training to drive change, especially through bystander CPR education, school-based training and public access defibrillation. From Santa Cruz to the Resuscitation Academy in Seattle, the emphasis is on making the simple feel possible: hands-only CPR, early defibrillation and empowering ordinary people to act. The result is more than a nonprofit or a campaign. As Rob notes, this is a movement. Memorable quotes “For every minute that a person's heart has stopped, their chance of survival decreases by 10%.” — Hilary Gates “Life and death is defined by geography.” — Bob Davies “There are vulnerable, voiceless people living on the margins who need a voice.” — Hilary Gates “The main way that people save more lives is they care.” — Bob Davies “Every podcast that Hillary and I are involved with is actually sponsored by R&D. Rip off and duplicate, show up, take our stuff, go and save lives with it.” — Rob Lawrence Additional resources Six Minutes to Live Six Minutes to Live mini documentary Episode timeline 01:34-02:14 – Rob Lawrence introduces the episode and welcomes Hilary Gates and Bob Davies. 02:21-03:21 – Hilary Gates shares her background as an educator turned paramedic and cofounder of Six Minutes to Live. 03:48-08:14 – Bob Davies recounts his experience as a paramedic and journalist, including his USA Today investigation into EMS performance disparities. 08:24-10:50 – Rob asks what has changed in 20 years; Bob discusses the enduring formula, new technology and the energy of younger clinicians. 11:08-13:02 – Hilary explains why Six Minutes to Live was founded and frames cardiac arrest survival as an issue of injustice and community responsibility. 13:13-17:08 – Rob asks what Six Minutes to Live is and how it fits among other advocacy organizations; Bob and Hilary describe its role as a connector and storyteller. 18:04-18:39 – Rob resets the conversation and asks what the organization is doing now. 18:50-20:47 – Hilary describes the Santa Cruz partnership, community CPR training and support from donors and local agencies. 21:12-23:47 – Bob highlights their upcoming workshop at the Resuscitation Academy in Seattle and the power of systems that care enough to measure and improve. 24:00-25:20 – Rob offers a transatlantic explainer connecting Eisenberg, Utstein and UK ambulance response standards. 25:24-28:41 – Hilary discusses community myths about CPR and AEDs, and the need to simplify action for laypeople. 28:48-31:02 – Bob outlines what is next: documentaries, deep listening, connecting voices and helping movements grow organically. 31:17-33:01 – Rob and Hilary talk about creating local champions, liability concerns and getting communities to act. 33:13-34:47 – Rob asks the closing question; Hilary urges EMS clinicians to become local champions for simple lifesaving actions. 35:22-37:20 – Bob closes with a call for EMS professionals to confront the “little secrets” they know and act on them. Email editor@ems1.com to share feedback. 

EMS on the Hill isn’t just a date on the calendar — it’s the profession’s annual moment to stand in front of Congress and tell the EMS story with clarity, confidence and unity. In this edition of EMS One-Stop, Rob Lawrence is joined by NAEMT President, Chris Way, to preview EMS on the Hill (March 25–26, 2026) and explain why this event matters now more than ever: EMS is where most Americans first enter the healthcare system, and the care delivered in the field is no longer “drive-you-to-the-hospital medicine.” Chris and Rob also unpack what’s changed — the scale of collaboration across national organizations and the discipline of going to Capitol Hill with aligned priorities and a shared message. They walk listeners through the event flow (Education Day, briefings, Hill visits, awards and reception), the importance of working relationships with staffers, and the advocacy “ask” that could reshape the future: reimbursement for treatment in place, mobile integrated healthcare/community paramedicine, and sustainable support for initiatives like prehospital blood. The throughline is simple: show up, speak with one voice, and translate momentum into legislative wins. Additional resources: EMS on the Hill Day One voice, one profession — EMS leaders open summit with call for unity and coordinated action Episode timeline 00:00 – Chris Way frames the goal: becoming a trusted, go-to EMS resource for lawmakers 00:52 – Why EMS on the Hill matters; EMS as the front door of healthcare; call to action 02:16 – Advocacy theme and EMS on the Hill as the seminal D.C. event 03:27 – Kansas City summit recap; commitment to making it annual; “stronger together” 05:39 – Evolution of EMS on the Hill into a multi-organization partnership; one message 08:24 – Logistics overview begins: dates, hotel, education day, briefings, awards 10:16 – How to succeed in legislative meetings: reading the room, time limits, staffer relationships 17:14 – Priority bills: treatment in place, MIH/CP, whole blood, NAMSP priorities 21:02 – “This is ongoing” collaboration: monthly cross-organization calls, broader coordination 24:05 – Chris shares his recommended approach: prep, priorities, cards/coins, questions, follow-up 27:34 – Rob’s add-ons: photos after meetings, tagging lawmakers, comms/PR value 28:59 – Final logistics recap; what to expect as a first-timer at state tables 30:37 – Chris closes: unprecedented partnership, focus to “get this done” 31:14 – Rob plugs state-level advocacy (CAA Stars/Capitol Day) Email editor@ems1.com to share feedback. 

Recorded on location at the EMS Association Summit in sunny Kansas City, this edition of EMS One-Stop captures something that’s been building for a while across the profession: real momentum. In the first half, Rob Lawrence sits down with Bill Seifarth, CEO of the National Registry of EMTs, to unpack what the Registry is today; how its mission has evolved; and why partnerships, research and continued competence sit at the heart of public trust when 911 is called. In the second half, returning guest Patrick Pianezza joins Rob to talk Code 3, the top streaming EMS movie’s impact on providers and families and what comes next. Across both conversations, the theme is unmistakable. When EMS organizations collaborate, align messaging and show up as one voice, the profession becomes harder to ignore and easier to support. The summit becomes more than a meeting. It becomes a signal. Episode timeline 1:02 – Introduction of Bill Seifarth; brief personal bio and career path 2:01 – “National Registry 101”: Bill explains the mission and what the Registry does 2:53 – Research focus: the Registry’s fellowship and EMS research priorities 3:31 – “Bread and butter”: entry-level and continued competence assessment and why it matters to the public 4:33 – Rob notes the Registry’s growing national presence; Bill outlines advocacy-through-partnership 5:08 – Preview of next year’s summit; participation in EMS on the Hill and NCSL with multiple EMS orgs in one booth 6:33 – Why the summit matters: state associations and national partners coming together under one roof — it’s a sold-out inaugural event; education, networking and shared experience highlighted 10:52 – Next stop: EMS on the Hill; “hunting in a pack” 12:20 – Bill’s closing: partnership, collaboration, synergy and supporting the profession 13:38 – Transition: Rob introduces Patrick Pianezza, co-writer of Code 3 14:41 – Patrick reflects on the film’s reception — especially among working providers 15:33 – Patrick shares the origin story: a “homework assignment” turned full-length film 17:39 – Where to watch: Apple/Amazon to rent or purchase; streaming on Hulu; performance metrics shared 18:30 – What’s next: pitching a TV series and interest in a sequel; realities of funding and IP ownership 21:33 – Discussion of the “Mr. President” scene and the intentional visual tension-building 24:19 – Patrick addresses feedback and the goal: honest portrayal and conversation-starting, not villainizing partners 27:41 – Leadership pipeline point: great clinicians aren’t automatically great leaders; mentorship matters 30:15 – Closing theme returns: one voice, fewer scattered voices, more impact for the profession 31:20 – Rob wraps: summit takeaways, guests, and a final nudge to watch Code 3 Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for future episodes. 

In this episode of EMS One-Stop, Dr. Linda Dykes joins Rob Lawrence from the UK for a wide-ranging, transatlantic conversation that starts with workplace culture and ends with a practical look at how health systems can keep patients safely at home. In the first half, Linda breaks down her newly published (open-access) qualitative paper, provocatively titled “It’s not bullying if I do it to everyone,” drawn from UK NHS “Med Twitter” responses: a raw, heartbreaking window into the red flags of toxic workplace culture, how bullying is experienced in the eye of the beholder, and why incivility and silence are not just HR problems — they’re patient safety threats. In the second half, Linda brings listeners into the UK’s evolving admission alternative world: frailty care at home, urgent community response models, and the increasingly important interface between EMS and community-based teams. She explains the UK’s SPOA (single point of access) concept, why she dislikes the term “admission avoidance,” and how ED crowding and access change the risk-benefit equation for hospital vs. home. Rob connects the dots back to the U.S. reality — reimbursement, APOT/wall time, treatment-in-place policy — and why this work is becoming a shared challenge on both sides of the Atlantic. Timeline 00:51 – Rob opens, recaps NAEMSP in Tampa and recent content. 02:25 – Rob introduces Linda as the “triple threat” (emergency medicine, primary care/GP, geriatrics) and tees up two-part discussion. 05:39 – Rob introduces Linda’s paper: “It’s not bullying if I do it to everyone.” 06:13 – Linda explains why toxic culture is increasingly visible and how the tweet prompt became a dataset. 07:33 – “Flash mob research group” forms; Linda explains social-media-to-qualitative methodology and limitations. 10:03 – Rob asks about bias; Linda clarifies purpose: insight, not representativeness. 16:39 – Linda defines gaslighting and why it’s so destabilizing. 18:21 – Reactions to publication; resonance, sharing and uncomfortable self-reflection on learned behaviors. 20:18 – The “16:55 Friday email” as a weapon — and as an accidental harm. 23:29 – Leadership as “the sponge” — absorbing pressure rather than passing it down. 25:27 – “One thing right now”: know the impact your words can have, especially on vulnerable staff. 26:41 – Rob on “pressure bubbles,” micro-movements and atmospherics: how leaders shift climate without realizing it. 30:53 – SPOA explained: single point of access and urgent community response behind it. 33:03 – EMS interface: calling before conveyance to find safe pathways to keep patients at home. 35:47 – Linda on mortality risk of access block/long waits and how that reframes risk decisions. 37:19 – Evolving models: primary care-led response vs. hospital at home approaches. 39:34 – Clinical myths challenged: oral antibiotics sometimes non-inferior to IV in conditions we assumed needed admission. 40:34 – Outcomes: hospital at home trial signals safety and fewer patients in institutional care by 6 months. 42:00 – Telemedicine/telehealth: underutilized but useful; when you still need a senior clinician in person. 44:50 – Closing takeaways: read the paper (with trigger warning); admission alternative work is deeply satisfying. Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

In this episode of EMS One-Stop, host Rob Lawrence welcomes John Sammons, an advanced practice paramedic with Wake County EMS, a peer support team member and a key leader in the NAEMT Lighthouse Leadership Program. John sits at the intersection of system design and human performance, helping build the kind of operational and cultural scaffolding that keeps clinicians effective, healthy and coming back tomorrow. In this episode of EMS One-Stop, host Rob Lawrence welcomes John Sammons, an advanced practice paramedic with Wake County EMS, a peer support team member and a key leader in the NAEMT Lighthouse Leadership Program. John sits at the intersection of system design and human performance, helping build the kind of operational and cultural scaffolding that keeps clinicians effective, healthy and coming back tomorrow. | MORE: Peer support teams: How to build trust and maximize effectiveness This week’s conversation goes beyond “be more resilient” and into the practical realities of burnout, moral injury, mentoring and culture, including the role of frontline and unofficial leaders in shaping what “normal” looks like inside an agency. John also shares the Wake County approach to peer support: presence first, then resources, plus the power of finding your people: your team, your tribe, your board of directors. Memorable quotes from John Sammons “We have folks that don’t stay in the profession. We have folks that leave. We have folks that unfortunately develop substantial mental health crises up to and including, unfortunately, suicide in our profession.” “What an amazing privilege that we’re invited into somebody’s home to take care of them and to figure it out.” “Every one of those people expects to call 911 and have an expert show up and solve the problem.” “I work to live, I don’t live to work. And that’s a great philosophy to have.” “Everybody goes home ... but there should be an addendum on the bottom of it that says, ‘but everybody comes back tomorrow.’” “Nobody gets us like we get us.” “Leadership is action, not a title.” “Everybody has their bucket, and everybody’s bucket can only hold so much.” “Nobody got into this because we wanted to be crusty and angry and miserable and difficult to be around.” Episode timeline 00:40 – Rob opens the episode and introduces John Sammons and the theme: resilience and beyond 02:05 – John’s “Sammons 101” bio: Wake County APP, peer support, Lighthouse Leadership involvement 03:01 – Burnout data and why it matters for retention and wellbeing 04:16 – Wake County’s Advanced Practice Paramedic Program: the “three Rs” 05:03 – John’s post-COVID turning point: “I’m done ... I don’t want to do this anymore” 06:12 – What brings John back to work: purpose, people, privilege, challenge 09:16 – Prevention and balance: identity beyond the job, sleep, nutrition, purpose 12:15 – Peer support in practice: presence, triage, in-house clinician, canines, statewide resources 17:09 – Podcast/vodcast reminder and John’s slides supporting the discussion 18:14 – NAEMT Lighthouse Leadership: why relationships and peers are the real multiplier 20:39 – Mentorship as a resilience strategy: formal programs and informal investment 24:25 – Culture: administration vs frontline leaders vs unofficial leaders 28:06 – Closing reflections: remembering why we got into EMS 30:36 – Final takeaways Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for future episodes. 

In this episode of EMS One-Stop, Sophie Fuller — better known across social media as Paramedic Sophie — joins host Rob Lawrence for a candid, energizing conversation about what it really feels like to work in EMS right now: pride, the pressure, the burnout, and the culture issues that too many providers have been taught to silently absorb. Sophie is a critical care ground paramedic, flight paramedic, educator and president of the Tennessee Association of EMS Providers (TAEMSP), and she brings a provider-first lens to everything from leadership visibility, to mental health and pay equity. Together, Rob and Sophie dig into why Sophie started creating content in the first place (hint: burnout and the need to connect), how social media can be used as a force for good, and what “healthy” EMS culture should look like in practice. Sophie shares practical advice for crews and leaders alike: Be human Say the uncomfortable thing Stop normalizing harm Build systems that “care back” for the people doing the work Memorable quotes “We're just working in systems that haven't yet learned how to care back for the provider.” — Sophie Fuller “Management by walking about. Don't be stuck in the office. Don't say my door is always open because that relies on people coming in to see you. Get out and go and see them.” — Rob Lawrence “We love this job and that distracts us from the fact that it's also hurting us.” — Sophie Fuller “Just because it's normal doesn't mean it's healthy.” — Sophie Fuller “We confuse trauma with tradition.” — Sophie Fuller Additional resources: Follow Paramedic Sophie on: YouTube Tik Tok “The Next Shift : A mentorship workbook for EMTs and Paramedics” | E-Book, by Sophie Fuller “To Err is Human: Building a Safer Health System” - PubMed Episode timeline 01:00 – Rob introduces Sophie Fuller (“Paramedic Sophie”) and frames the influencer vs. “effluencer” concept 02:14 – Sophie’s origin story: graphic design → hospital tech → EMT → volunteer fire → paramedic → critical care → flight 06:16 – TAEMSP: why Tennessee needed a provider-level association and the shift toward legislative advocacy 08:05 – Why she started with social media: two full-time 911 jobs, low pay, burnout and the need for an outlet/connection 09:32 – Defining EMS burnout: the “jar on the shelf” and cumulative strain that becomes chronic fatigue 13:26 – Sophie’s guidance to providers: vulnerability, telling the truth and not letting naysayers silence needed conversations 16:00 – Sophie’s message to leadership: don’t be the “Wizard of Oz” — show up, communicate and stay connected to crews 20:26 – EMS culture: self-sacrifice, silence, “earning your place through suffering,” and confusing trauma with tradition 23:10 – Sophie’s book “The Next Shift”: a field guide to “learn, lead and last” in EMS 26:03 – Mistakes and “just culture”: reporting, mentoring, anonymous reporting systems, and learning vs. blame 32:08 – Closing challenge: stop normalizing harm; speak up for culture and patient care 33:14 – Where to find Sophie online and how large her platform has become Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

In this episode of EMS One-Stop, Rob Lawrence is joined by his own Medical Director, Dr. Maia Dorsett, to unpack the 2025 NEMSQA Measures Report — a deep dive into trauma-focused quality measures built largely from NEMSIS data. Dr. Dorsett frames the discussion around the central aim of quality improvement: Are we doing a good job? Are we delivering the best possible care? How do we get better? From pediatric vital signs to traumatic brain injury (TBI) fundamentals, she walks listeners through what the report reveals, what it can’t reliably measure yet, and why some of the “sexy” procedures are too rare to serve as useful system-wide metrics. The conversation highlights a recurring theme: fundamentals matter most. Dr. Dorsett explains how measures like complete vital signs and avoiding secondary brain injury in TBI (hypoxia, hypotension, hyperventilation) can drive meaningful outcomes — even during relatively short prehospital intervals. She also points out where current measurement approaches unintentionally create documentation burden for clinicians, arguing that systems should do more of the “figuring out” (like trauma center designation and prenotification capture) without requiring extra clicks. The episode closes with a call to action: anyone can join NEMSQA, contribute to the work, and help shape what EMS quality measurement becomes next. Memorable quotes from Dr. Maia Dorsett “I think the most fundamental question in quality improvement is, are we doing a good job?” “I think part of the value of this report is specifically looking at those things and saying what should we be measuring using NEMSIS data or how should things be integrated into that database so that the answers are there rather than needing to be documented on each individual case?” “If there's one thing that you're going to take away from this trauma report is that, the sexy stuff is important, but it happens rarely. And if you want to improve care in your system, it's about the fundamentals of good care.” Additional resources NEMSQA 2025 Report Release EMS One-Stop: Leading through momentum: Dr. Douglas Kupas on steering NAEMSP Episode timeline 00:31 – Rob welcomes listeners; introduces the 2025 NEMSQA measures discussion and notes prior episode with Dr. Jeff Jarvis 01:10 – Dr. Dorsett joins; holiday surge discussion and flu impact on EDs and admissions 03:08 – Dr. Dorsett explains her role as co-chair of NEMSQA’s Measure Analysis and Research Committee; trauma focus of the 2025 report; pain measures not included due to active research 05:00 – NEMSIS scale and opportunity: extracting meaningful measures from a massive national dataset 05:35 – Dr. Dorsett on what NEMSIS measures well vs. what it shouldn’t force clinicians to document (system should determine trauma center status) 07:46 – “HALO procedures” table: why rare interventions shouldn’t become national quality measures 10:17 – Trauma 08: complete vital signs; pediatric gap (adults ~93% vs pediatrics ~85% in discussion) 14:22 – TBI measures: preventing secondary brain injury; why fundamentals outperform “sexy” fixes; correction rates for hypotension/hypoxia discussed 21:39 – Trauma 04: trauma triage criteria and transport to trauma centers; why national measure looks low; documentation field limitations 24:17 – State collaboration comparison: using state trauma center designation data shifts performance dramatically (often 75–90%+ in examples) 26:55 – Trauma 14: hospital prenotification; importance and measurement challenges (multiple modalities, inconsistent capture) 30:01 – Rob raises operational/policy concerns about trauma alerts and incentives; Dr. Dorsett adds nuance about local criteria variation 33:22 – Closing: Dr. Dorsett’s “fundamentals matter” takeaway; impact at scale 34:44 – Dr. Dorsett plugs joining NEMSQA as an individual/agency; committees are open 35:31 – NAEMSP Tampa preview; Dr. Dorsett: “The people” are why she goes — leaves energized with new ideas Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

Dr. Douglas Kupas joins Rob Lawrence to kick off EMS One-Stop in 2026, reflecting on his first year as President of NAEMSP — a year he describes as fast-moving, complex and occasionally “whack-a-mole,” with emerging issues demanding real-time leadership while long-term priorities still had to move forward. He shares what he’s learned about the presidency, the value of NAEMSP’s leadership “bench strength,” and why advocacy and coalition-building across national EMS organizations has become more coordinated, more strategic and more essential. The conversation then turns to what’s immediately ahead: the NAEMSP Annual Meeting in Tampa (late January), including pre-conference courses, the flagship Medical Director’s Course, and a packed scientific program. Kupas highlights a keynote focused on transforming battlefield trauma care; major research programming through oral abstracts and hundreds of posters; and high-impact sessions spanning clinical care, operations, legal issues, and international perspectives — reinforcing why the Tampa meeting remains a must-attend event for anyone serious about the science and future of EMS. Episode timeline 00:00 – Rob tees up NAEMSP Annual Meeting growth as a “good problem to have” 00:50 – Welcome/Happy New Year 2026; Dr. Kupas introduced as first guest of the year 01:45 – Year one as NAEMSP president: what’s surprised Dr. Kupas, pace of work, governance “bench strength” 04:26 – NEMSAC termination: what happened, what NAEMSP hopes comes next 07:02 – Building the pipeline: medical student/resident interest group, travel support ideas 08:47 – “Hot off the press:” NAEMSP accepted into WHO Acute Care Action Network 10:08 – Advocacy “hunting as a pack:” overlapping national orgs, EMS on the Hill coordination 12:40 – Why Hill visits work: stories, staffers and why first-timers matter 16:48 – “White hat” advocacy and patient-centered priorities; ED wall time as a key issue 20:07 – Tampa preview: “It’s not just for docs,” NAEMSP membership structure 22:11 – Pre-cons overview: Medical Director’s Course, QI workshop, MIH, ventilation, blood, TECC 23:55 – Keynote: Dr. Frank Butler and special intro by Dr. Bob Mabry; Grand Rounds obstetric focus 27:45 – Major legal session format and why legal content draws a crowd 29:28 – Space constraints and future planning: small convention centers; San Diego “buyout” scale 31:49 – Research explosion: oral abstracts, posters, receptions; better ways to access abstracts 34:39 – “Meat of the conference:” operations, clinical topics, international speakers/learning 36:49 – Closing question: Bill details Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

As the year wraps, Rob Lawrence welcomes back the “EMS Avenger” Jimmy Apple for a fast-moving, end-of-year pulse check on the EMS universe — through the lens of social media, research and what frontline clinicians are actually saying when the mic is on and the comments are open. Building on last week’s data-and-trends conversation , this episode pivots into “the world according to Jimmy Apple” and his alter ego, the EMS Avenger, exploring what’s made providers lean in, push back or flat-out declare “enough is enough.” | SHARE YOUR STORY: A call for real stories from the EMS field, station and beyond  From burnout and workforce conditions to AI-assisted ECG interpretation and the rise of microlearning, the conversation lands on a central theme: the future of EMS isn’t just protocols — it’s people, technology and how we choose to learn, adapt and debate. Jimmy also names his “paper of the year” on spinal immobilization, explains how he handles disagreement without falling into “quicksand arguments,” and previews a packed 2026 speaking calendar — plus a relaunch of his podcast. Memorable quotes “If we can just verify that you’re retaining the information, that’s much more important than the veracity of how long it took you to get that information.” — Jimmy Apple “You can catch more flies with honey than you can with vinegar.” — Jimmy Apple “That’s the future; is that literally, we’re going to swipe it, absorb it and swipe away again.” — Rob Lawrence “My paper of the year is the paper that was published on spinal mobilization … It does not support the use of backboards as anything other than an extrication tool.” — Jimmy Apple “I think that a big push that I’m making this year is to really start talking about the EMS provider as the person.” — Jimmy Apple Episode timeline 00:56 — Rob welcomes listeners, references year-in-review data and notes ambulance thefts continue to trend. 01:38 — Rob brings Jimmy back and asks for a quick summary of Jimmy’s year and growing reach, and the top themes Jimmy has seen. 04:12 — Jimmy identifies provider conditions and mindset as the dominant theme and describes discussion of collapse/collapsing systems. 06:12 — Jimmy explains social media as the pulse point and highlights burnout, anger and provider frustration. 06:52 — Jimmy pivots to technology’s growing role and EMS resistance to tech encroachment in practice. 07:23 — Rob connects the tech thread to conference observations (Axon, AI). Jimmy gives examples (AI 12-lead, apps) and argues tech advancement shouldn’t be rejected due to “skill deterioration” fears. 09:34 — Rob asks Jimmy’s “how do you explain complex concepts quickly?” Jimmy uses the Michelangelo anecdote to describe stripping concepts to essentials; critiques padded, time-gated education. 12:29 — Jimmy argues for education credit models that recognize microlearning and self-directed learning if retention can be verified. 14:04 — Rob asks for standout research; Jimmy discusses RSI/induction agent considerations, pressors debate and prehospital antibiotics. 16:47 — Rob and Jimmy preview NAEMSP’s annual meeting (“research Disney”), value of posters, networking and clinical depth. 18:26 — Jimmy names spinal immobilization evidence review as his “paper of the year” and explains its conclusions. 21:36 — Rob asks how Jimmy handles disagreement/detractors with a larger platform — Jimmy describes disagreement as healthy, focuses on respectful pushback and staying anchored in data. 29:00 — Final question: Jimmy emphasizes “provider as person,” healing the clinician and a sponsored podcast relaunch in January. Additional resources Meet the EMS Avenger: Saving lives with kindness and content. TikTok sensation and pediatric critical care paramedic Jimmy Apple shares his rise in EMS education, battling misinformation with heart and hustle Jimmy Apple’s “paper of the year:” Millin MG, Innes JC, King GD, Abo BN, et al. “Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries — A NAEMSP Comprehensive Review and Analysis of the Literature.” Prehosp Emerg Care. 2025 Aug. Connect with Jimmy Apple, better known as The EMS Avenger: TikTok — Jimmy offers short-form, evidence-based EMS content here: @emsavenger Instagram — Engage with in-depth reels, visuals, and professional updates: @emsavenger X (formerly Twitter) — Follow EMS commentary, conversation, and boosts: @EMSAvenger Facebook — Join the group for discussions and shared insights: EMS Avenger community Apple Podcasts — Listen to “EMS Avenger: 20 Minutes to Save the World”: Weekly podcast series AAA & AIMHI EMS Media Log: EMS Intel Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

As EMS closes out 2025, host Rob Lawrence is joined by Matt Zavadsky (PWWAG) and Rodney Dyche (Patient Care EMS Solutions) for their second annual EMSIntel.org “year in review” conversation — a fast-moving tour through the biggest stories shaping the EMS profession. Drawing from the EMSIntel news log (now 3,849 stories as of the morning of recording), the trio connects what’s making headlines to what EMS leaders are experiencing on the ground: unstable economics, governance pressure, system redesign and rising operational risk. The discussion lands on several recurring themes: economic sustainability as the dominant issue; the real-world politics of tax levies and “essential service” designations; the ongoing obsession with response times (and what they cost); preventable ambulance thefts escalating in severity; and the importance of measuring and publishing clinical outcomes and meaningful performance metrics. The through-line: communities are being forced into more honest conversations about what they can afford — and what EMS should look like going into 2026. | SHARE YOUR STORY: A call for real stories from the EMS field, station and beyond Memorable quotes “Having a thoughtful conversation about what your system needs to look like on the go forward is paramount.” — Rodney Dyche “If you don’t talk about yourself, somebody else will, and then you don’t control the narrative.” — Rob Lawrence “Our No. 1 focus really needs to be on the economic sustainability of these systems because we are past the breaking point.” — Matt Zavadsky “Response times equals speed; speed equals crashes.” — Rob Lawrence “These theft incidents are … in almost all cases, 100% preventable by an aftermarket device … probably for 100 or $150.” — Rodney Dyche “Response times are expensive. The shorter that you want your response times, the more money it’s going to take.” — Matt Zavadsky “Across every provider type … the fee-for-service revenue is 50% to 60% below the cost of providing service. So when somebody says to you, ‘I can do this for free,’ ask more questions.” — Matt Zavadsky “Response times are used as a cudgel.” — Rodney Dyche Episode timeline 01:11 – Rob introduces the end of 2025 reflection and 2026 look-ahead; welcomes Matt Zavadsky and Rodney Dyche for the second annual EMSIntel year-in-review. 02:26 – Rodney reports the EMSIntel log count (“3,849 as of this morning”); Rob explains EMSIntel’s purpose: curating national EMS stories to identify themes and brief stakeholders. 04:13 – Matt names the year’s biggest issue: economic sustainability; the fiscal model is broken and impacts everything else. 06:32 – Matt walks through the “AnyTown EMS” trajectory: communities can’t sustain old models, must define service levels, use system intelligence, and redesign for a modern “2028 model.” 09:06 – Matt cites the Medicare/RAND cost collection findings and warns that fee-for-service revenue sits far below actual costs; “ask more questions” when someone promises “free.” 10:12 – The group discusses communities pursuing tax levies and essential-service framing; Rodney contrasts places that pass funding measures with places that don’t, and highlights local politics and competing priorities. 11:52 – Matt clarifies that “essential service” means different things to the public versus statute; agencies need trust, transparency and real community education to succeed at the ballot box. 13:50 – Rodney describes the “cost of readiness” misunderstanding (public sees mileage, not readiness); Matt pushes proactive reporting (monthly/quarterly/annual) to build credibility. 15:35 – Matt pivots to response times: they’re expensive, clinically relevant in a small fraction of cases, and should be approached with evidence-based expectations and better triage/EMD practices. 18:14 – Rodney connects hot responses to preventable intersection crashes and modern driver realities; the discussion frames safety risk as a growing operational storyline. 20:21 – Matt adds an editorial caution that crashes are not confined to any one sector; points to recent examples including serious injuries during responses. 22:37 – Rob returns to ambulance thefts; Rodney calls most thefts preventable; Matt argues the basic lock discipline exists already and presses for stronger accountability and accreditation-style best practice. 26:11 – Rob flags downstream legal and regulatory risk (litigation exposure after stolen-unit crashes; DEA-controlled substances security implications). 26:52 – Rodney raises staffing; notes fewer staffing stories than 2024 but questions whether the situation is truly better; mentions earn-to-learn pipeline concerns. 28:13 – Matt describes the shift toward tiered deployment and greater EMT utilization, reducing pressure to staff large numbers of paramedics for calls that don’t require that level. 30:17 – Matt emphasizes outcomes and meaningful performance metrics; argues many systems still report the wrong measures and should lead with clinical metrics, patient experience, and quality indicators. 31:08 – Rodney reinforces that response times get weaponized in governance decisions; notes boards can be swayed by “advanced skills” narratives rather than outcome data. 33:25 – Forward-looking wrap: Matt highlights daily calls from communities that “can’t afford this anymore” and urges leaders to seize the redesign opportunity; Rodney echoes the need for planning and honest community conversations. Additional resources: AAA & AIMHI EMS Media Log: EMS Intel Fast & spurious: America keeps losing ambulances and the fix is cheap Callouts, chaos and career killers: The biggest EMS stories of the year Enjoying EMS One-Stop? Email editor@ems1.com to share feedback or suggest guests for future episodes. 

In this episode of the EMS One-Stop podcast, host Rob Lawrence revisits an issue close to the heart of every EMS professional: creating a permanent National EMS Memorial in Washington, D.C. Rob is joined by Tony O’Brien and James Robinson from the National EMS Memorial Foundation to provide a clear, candid update on where the project stands, why it matters, and what still needs to be done. From the Weekend of Remembrance to the dream of a year-round place of solace and reverence in the nation’s capital, this conversation lays out the long road from idea to reality — and why EMS, as James puts it, truly deserves this. Tony and James walk listeners through the 24-step federal Commemorative Works Act process, the hard work of narrowing 312 potential sites down to three, and the current push to reauthorize the Foundation’s federal authority through House Resolution 2196 and Senate Bill 2546. They explain the preferred site in front of the Hubert H. Humphrey Building (HHS), the partnership with MIT’s School of Architecture and Urban Risk Lab on a powerful design, and the practical realities of funding, sponsorship and bureaucracy. Most importantly, they end with a clear call to action for the EMS community: contact your elected officials, donate what you can, and help spread the word so that a permanent memorial to EMS can finally take its place in Washington, D.C. Additional resources EMS Memorial EMS Memorial Bills: HR 2196  S2546  2025 National EMS Weekend of Honor recognizes 29 fallen EMS workers ‘Never forgotten’: 2025 Moving Honors procession honors 29 EMS providers lost in the line of duty Episode timeline 00:44 – Rob introduces the episode, sets the scene for a revisit of the National EMS Memorial effort, and welcomes guests Tony O’Brien and James Robinson. 01:30 – Tony and James share their backstories. 03:53 – Tony explains the origins of the Foundation at the Weekend of Remembrance/Weekend of Honor and the realization that EMS needs a permanent memorial people can visit year-round. 06:54 – James outlines the Commemorative Works Act, the 24-step process, and how the Foundation has reached step 15-16 over roughly 15 years. 07:54 – Tony details the grueling site-selection work: visiting 312 sites, environmental and noise studies, traffic and solitude considerations, and narrowing to three candidate locations. 10:48 – James describes the need for an Act of Congress to begin, Congressman Stephen Lynch’s early sponsorship, and the 2018 authorization that started a 7-year clock — complicated by the pandemic and federal shutdowns. 13:12 – Tony explains how the initial authorization expired, the need for reauthorization and the most recent Senate subcommittee hearing on federal lands where James testified. 16:41 – James and Tony frame the new bills: Senate Bill 2546 and House Resolution 2196, their bipartisan sponsors and the push for more co-sponsors. 19:49 – Tony lays out the three-point call to action: contact Congress, donate via EMSMemorial.org, and follow/share @EMSMemorial on social media. 23:06 – Tony describes the three remaining sites and why Independence Ave. & 3rd St SW, in front of HHS, is the preferred location. 24:42 – Tony highlights the pro-bono design work by MIT’s School of Architecture and Urban Risk Lab, and the deep engagement with providers, families and survivors. 26:32 – James explains the historical nexus of EMS with HEW/HHS and why the Humphrey Building plaza offers the right reverence, proximity to the Capitol and connection to EMS history. 29:01 – Tony and James discuss next steps: reauthorization first, then finalizing site and design to approach major sponsors with clear answers on location, look and cost — while acknowledging the project has been bootstrapped so far. 32:03 – Tony reassures donors: the Foundation is a 501(c)(3), the board are all volunteers with only necessary professional services paid from donations. 33:13 – Tony gives shout-outs to the National EMS Memorial Service and the National EMS Memorial Bike Ride, and explains how the three organizations’ missions align. 37:12 – Rob recaps the journey, reinforces the call to action, and closes the show with thanks to Tony and James and a reminder to visit EMSMemorial.org and like/subscribe to EMS One-Stop. Rate & review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

Recorded on the floor of the EMS|MC EMSpire Conference in Charleston, South Carolina, this episode of EMS One-Stop finds host Rob Lawrence in conversation with long-time collaborator and EMS advocate Matt Zavadsky. Fresh off the longest federal government shutdown in history, Rob and Matt unpack what the hyper-turbulence in Washington really means for EMS: suspended Medicare extenders, disrupted grant programs, agencies taking out loans just to meet payroll and training programs put on hold. They break down NAEMT’s flash poll on the shutdown’s impact, the promise of the Treatment in Place (TIP) legislation, and why associations “hunting as a pack” on Capitol Hill matters more than ever. Along the way, they spotlight EMSIntel.org as a national barometer of EMS funding, staffing and response time crises, and issue a clear call to action for providers, billers and leaders to use association tools to contact their members of Congress. | MORE: Government reopens: What EMS providers need to know right now In the second half, Rob is joined by Dr. Shannon Gollnick, paramedic, EMS leader and organizational psychologist, to explore how artificial intelligence is reshaping EMS — right now. Shannon makes the case that AI is “not the future; it is the present,” and that agency leaders must urgently build literacy, policies and guardrails around its use. They dig into the difference between HIPAA-compliant, embedded AI in ePCR systems, and risky open tools like ChatGPT, touching on hallucinations, embedded code and emerging Medicare fraud-detection programs. | MORE: Artificial to augmented intelligence. How Dr. Shannon Gollnick wants EMS to work smarter, not harder Rob and Shannon talk about AI as a powerful but potentially dangerous tool — “like having a tiger” — and outline practical steps for chiefs: Ask: “Do we have an AI policy?” Define what AI can and cannot be used for Insist that every AI-generated work product is double-checked by a human before it hits the record Memorable quotes “We weren't here to actually scare you off it. We're here to let you know that it's here, but it's like having a tiger, right? We all love to have a tiger, but it has to be contained in some sort of guard, otherwise it's going to run rife and cause havoc, and we don't want that.” — Rob Lawrence “This is part of the hyper-turbulence that's occurring in EMS right now.” — Matt Zavadsky “So I think the message for the profession right now is, now is not the time to put your foot on the brake. It's time to put your foot on the gas.” — Matt Zavadsky “We put the fun into function.” — Dr. Shannon Gollnick “I think it's important to understand that AI is not the future. It is the present. We are currently here right now. And it's nothing to be afraid of.” — Dr. Shannon Gollnick “If you're not doing it, I promise you that your staff is doing it and they're playing around with AI.” — Dr. Shannon Gollnick “Guardrails don't exist from a congressional standpoint. They don't exist from a regulatory standpoint. The technology is moving far too fast. So we as agency leaders have to take the lead in putting up some of those guardrails.” — Dr. Shannon Gollnick “There are ePCR software out there that are using proprietary AI that will use AI-generated narratives. And that absolutely is 100% good to go. What we don't want to see is our crews putting in their ChatGPT to have ChatGPT write their narrative.” — Dr. Shannon Gollnick “ChatGPT has embedded code inside of it that you can't see, but that code is there ... so what we're kind of afraid to do is to say, hey, what happens 6 months from now, 8 months from now when Medicare does an audit, they run your ePCRs and find all of this embedded code from ChatGPT ... you open yourself up for a lot of compliance issues.” — Dr. Shannon Gollnick Additional resources: EMS Intel EMS News Tracker American Ambulance Association Advocacy NAEMT Advocacy EMS shutdown survival: What leaders need to know now Charting the future: How AI is rewriting the EMS narrative Episode timeline: 00:21 – Rob introduces guest Matt Zavadsky 02:02 – Rob recaps the 40-plus-day federal government shutdown, questions about reopening, and his upcoming return to Capitol Hill for renewed advocacy 02:02 – Matt frames the shutdown as part of the “hyper turbulence” in EMS; explains the regulatory suspensions, pauses in Medicare extenders and grants, and how cash-flow uncertainty forced some agencies to take out loans just to make payroll 03:04 – Matt details NAEMT’s flash poll (408 agency responses) showing suspended training and grant-funded programs, and warns of a possible repeat shutdown around January 30 03:54 – Rob and Matt discuss the reopening of government, ongoing bipartisan work, and the risk that everything “comes to a grinding halt” again if Congress can’t agree 04:51 – Matt explains why NAEMT released the shutdown-impact poll even as government reopened and stresses the need to keep pushing for permanent relief from Medicare extenders and advancement of key bills like Treatment in Place (TIP) 06:03 – Matt outlines the House and Senate TIP companion bills and why Medicare paying for treatment in place is better for patients, EMS, the health system and the Medicare trust fund 06:54 – Rob notes broad association/provider support and professional lobbyists on the Hill; Matt stresses that field providers, administrators and billers must still use association legislative portals to send letters to Congress 08:08 – Matt describes a surge in communities reevaluating their EMS delivery models because of staffing, finance and subsidy challenges — “a great time to be an EMS consultant” 09:09 – Rob introduces EMSIntel.org as a curated clearinghouse of EMS news, used to show communities they aren’t alone; describes failed tax measures and funding referenda 10:15 – Matt cites EMS Intel data: ~85% of stories each month involve funding, staffing or response times; Rob and Matt stress the ubiquity of these themes from big cities to small towns 11:09 – Rob highlights mutual aid tensions and taxpayers questioning why they “pay to send our resources somewhere else;” both emphasize that hyper-turbulence and funding gaps are national issues 13:23 – Rob resets the scene from the EMSpire conference and recaps Matt’s Hill update before introducing Dr. Shannon Gollnick 14:41 – Shannon gives his backstory: in EMS since 1996, paramedic since 2002, progression into EMS leadership, doctorate in organizational psychology and focus on how organizations function 15:14 – “We put the fun into function.” 15:24 – Rob invites Shannon to talk AI, calling it “the specter we are embracing everywhere,” and references HIPAA concerns; Shannon opens with the core message: AI is not the future, it’s the present, and nothing to be afraid of 16:03 – Shannon urges leaders to build AI literacy, noting that if agencies aren’t using it, their staff and the younger generation already are 16:28 – Shannon emphasizes policy and procedure: AI guardrails aren’t coming from Congress or regulators, so agency leaders must define how AI will be used and where its limits are 16:55 – Rob reminds listeners that AI in EMS isn’t new, citing early monitor rhythm interpretation in the UK; Shannon underscores that crews already use AI tools and that unmanaged cut-and-paste practices can create billing and compliance risks 17:24 – Shannon explains the dangers of using open tools like ChatGPT for ePCR narratives: potential PHI exposure in a “black box” system and AI hallucinations generating plausible but false patient information 18:21 – Shannon describes how AI “wants to answer your question and make you happy,” leading to made-up details, and shares examples from testing minimal-input scenarios that returned overly detailed, inaccurate narratives. 19:03 – Shannon calls ChatGPT “kind of a snitch,” explaining embedded code markers that fraud detection tools — and increasingly Medicare’s AI-based “Wiser” program — can use to identify AI-written content in documentation 19:59 – Shannon warns about retrospective audits and compliance exposure if ChatGPT-coded narratives are found in ePCRs, noting that AI rules are still emerging and tech is outrunning regulation 20:51 – Rob summarizes the mixed message: AI is here and being built into devices and software, but there are real dangers. They discuss data going “to the cloud” — which Shannon defines as “somebody else’s computer.” 21:24 – Shannon frames AI as a powerful tool that can “put a lot of holes in the wall” if misused; he references fraudulent AI uses and deepfakes as emerging issues 22:05 – Shannon compares AI’s impact to the internet’s paradigm shift; Rob gives a “spoiler alert” about his own workflow using transcripts and ChatGPT agents, and notes the importance of reading and checking any AI-generated output 22:45 – Shannon reinforces that AI makes mistakes and cannot understand human context; he uses his “How you doing?” Joey Tribbiani vs. Tony Soprano example to illustrate contextual nuance 23:06 – Rob expands the context point with the “Friends”/“Sopranos” slide and reminds listeners that once AI-written words are published, “you said it.” Shannon highlights the WebMD effect and AI-driven self-diagnosis risks. 24:02 – They note that ChatGPT can generate long, complex diagnoses without sufficient patient context, leading to errant or misleading outcomes if misused clinically 25:00 – Rob summarizes: AI is here and, used correctly, is a good thing; advises chiefs to ask their teams, “Do we have an AI policy?” 25:27 – Shannon outlines what an AI policy should contain: acknowledgment that AI is here; clear, non-fearful framing; specificity on what decisions AI can support; and clarity on which tools (e.g., embedded EPCR AI) are allowed versus prohibited uses of ChatGPT 26:17 – Shannon stresses AI should not be used for clinical decision-making or clinical narrative writing; its role should be administrative only,

In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes Dr. Hezedean Smith, who spotlights the human and operational toll of Hurricane Melissa on Jamaica and the wider Caribbean. Dr. Smith draws from first-hand perspective from the ground, detailing catastrophic damage to homes, utilities, roads and communications — which compounded the workload and emotional burden for Jamaica Fire Brigade (JFB) firefighters and EMS providers. Dr. Smith highlighted the Brigade’s Amazon Wish List effort, which aims to route essential personal items and operational supplies directly to affected JFB members and stations to sustain continuity of operations and support responders’ families. After the break, Dr. Smith switched hats as the newly elected President of NEMSMA to outline the association’s renewed momentum: New association management support Expanded member services and credentials The inaugural NEMSMA Leadership Conference The NEMSMA Leadership Conference will take place in Washington, D.C., March 23-24, 2026, intentionally adjacent to EMS on the Hill to create a leadership-plus-advocacy “two-fer.” Highlights include keynote Gen. Robert Neller (Ret.), plus a deep bench of EMS leaders and educators. Memorable quotes from Dr. Hezedean Smith “Many homes destroyed, utility systems interrupted, critical infrastructure in terms of communities having the ability to communicate, leaving thousands displaced, even fire stations having operational challenges as it relates to communication and interoperability ... ” “I stayed in the local fire station. I wanted to be there with the men and women on the ground, to make sure that I had that communication, that constant contact with them.” “My focus will be on the firefighters and ensuring that we get enough supplies to go directly to the firefighters.” “We want to tear down silos. We want to redefine leadership and ensure that we continue to collaborate across this globe.” Additional resources: Jamaica Fire Brigade – Amazon Wish List National EMS Management Association (NEMSMA) NEMSMA Leadership Conference: Washington, D.C., March 23-24, 2026 EMS on the Hill, March 25-26, 2026, Arlington, Virginia International Journal of Paramedicine EMS One-Stop: General Robert Neller on ethical leadership and adaptability Episode timeline: 00:46 – Quick industry/policy update 01:27 – Set-up: Hurricane Melissa overview; impact stats and current situation 02:12 – Welcome Dr. Hezedean Smith 02:26 – Dr. Smith’s backstory: Jamaica roots, USAF medic, Orlando FD, two fire chief roles, GES Consulting, Caribbean EMS focus 04:20 – First reactions to Melissa: scale of damage; compounded human toll 05:58 – Deployment cadence: aligning with JFB command, CDEMA, national EOC; travel hurdles; rapid integration on arrival 08:28 – Why existing relationships matter; staying in-station with crews; supporting leaders and frontline needs 11:13 – Call to action: Amazon wish list for responders’ personal and operational needs; distribution via JFB logistics 13:20 – Specific needs (PPE, boots, clothing, hygiene, basic medical supplies) and the ongoing recovery realities 17:46 – NEMSMA — new president, renewed energy, new AMC, who NEMSMA serves 20:14 – Board/leadership shout-outs; programs (FTEP, ACPE), member services, momentum 22:49 – Conference preview (Mar 23–24, 2026, D.C.): theme — disruptive leadership; Gen. Robert Neller keynote; speaker lineup; proximity to EMS on the Hill 26:29 – IJOP collaboration and research-to-podcast pipeline; communications and sponsorship improvements 28:29 – Closing thanks; unified call to support JFB and engage with NEMSMA initiatives Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

From Medicare cuts to billing delays, Asbel Montes joins Rob Lawrence to share practical strategies EMS agencies can use to weather the reimbursement storm In this episode of the EMS One-Stop podcast, we tackle the fast-moving realities of a federal shutdown and what it means for EMS finance, reimbursement and day-to-day operations. Rob Lawrence sits down with Solutions Group’s Asbel Montes — a veteran of EMS reimbursement and policy expertise — to decode where Congress is (and isn’t), what CMS’s temporary claims hold really means, and how ambulance services can protect cash flow while preparing for potential reprocessing chaos if extenders aren’t promptly restored. Beyond the headlines, Montes lays out a pragmatic playbook: build a Plan B for cash continuity, align with your billing team on reprocessing workflows, and model exposure across payers tied to the Medicare fee schedule. The conversation then widens to balance billing — why federal change is unlikely soon and why state-level action is delivering practical protections — before closing with leadership lessons on adaptation, data and telling EMS’s story as a guide, not the hero. Memorable quotes from Asbel Montes “Our extender expired — that’s that additional payment that we get from Medicare of that 2%, 3%, 22.6% — it expired September the 30th, and it was tied to the House-approved CR that went over to the Senate.” “We’re solutions givers, as we say here at Solutions Group, not crisis managers. And if you have a plan, I can at least execute a plan.” “What turned out to be a smaller amount, now the cost associated with it, you started to really understand the complexities that really happened in people’s AR.” “If this lasts longer than 15 days … then I would basically have a plan in place. So I would be trying to find out from my billing team … what is your contingency plan to ensure I don’t see a hiccup in cash moving forward?” “The only way government can really invoke change is to make it hit where it hurts. And that’s what’s going on right now. They’re hitting the pocketbook and our industry is grappling with it right now.” Additional resources Asbel Montes: The government shutdown’s ripple effect on healthcare The Leadership Lab with Asbel Montes Episode timeline & key moments 00:21 – Why the shutdown matters to EMS reimbursement and operations 01:21 – Montes’s 101: role at Solutions Group; 28 years in EMS finance and policy 02:40 – Historical context: number and length of shutdowns; current Hill outlook 03:48 – The ambulance extenders expired (2% urban, 3% rural, 22.6% super-rural); CMS claims hold window 05:03 – Planning posture: realistic timelines; “we’re solutions givers, not crisis managers” 06:12 – Back-of-the-napkin math: short-term dollars vs. long-term reprocessing burden 07:43 – 2015–2016 déjà vu: retroactive fixes and the heavy lift for back-office AR 10:26 – Secondary impacts: VA eligibility, appeals, enrollments during a prolonged shutdown 11:11 – The “three-legged stool” for leaders: (1) have a plan with billing; (2) reconcile accounts & patient balances; (3) prevent cash-flow lag if more than15 days 14:06 – Framing the moment: “hurricane shutdown” response and recovery mindset 15:43 – Balance billing at the federal level: committee work, political pain and why movement is unlikely soon 18:19 – State action wins: consumer protections and access; examples of Medicare-indexed approaches 20:24 – Why ground ambulance stayed out of federal NSA; local regulation and state primacy 22:42 – “All politics are local”: using EMS’s public visibility to advocate for patients and providers 23:09 – Adaptation over preservation: seize the 6-18 month window; let data and clinicians lead reform 27:13 – Lawrence’s “Darwinism” takeaway: adaptation as survival 28:31 – The Leadership Lab podcast: purpose, cadence and upcoming guests; Montes’s leadership journey Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

In this episode of the EMS One-Stop podcast, our host, Rob Lawrence, sits down with Hollywood actor Rainn Wilson, who stars as Randy in “Code 3.” Known worldwide for his role as Dwight Schrute in The Office, Wilson has stepped into the world of EMS, portraying the life of a burned-out paramedic with both grit and humor. In the conversation, Wilson reflects on the process of bringing this story to life, his ride-along experiences in Los Angeles, and the powerful realities he uncovered about our profession. More than just a performance, Rainn has become an unexpected advocate for EMS. He speaks candidly about the underfunding of frontline providers, the emotional toll of the work and the sheer humanity that comes with being welcomed into people’s lives during their most vulnerable moments. Alongside the serious themes, he reminds us that Code 3 is also a comedy — one that captures the gallows humor, camaraderie and resilience medics carry with them on every shift. | MORE: Why ‘Code 3’ might be the most honest EMS film yet. From a ticking salary counter to fourth-wall confessions, this EMS road movie isn’t just another Hollywood take. It’s a love letter, a warning and a mirror. Memorable quotes from Rainn Wilson “Most of all, I just fell in love with the character of Randy.” “Bottom line, the fact that first responders are getting basically what people that work at Starbucks are getting paid really blew my mind.” “Well, one thing I never thought of, maybe stupidly so, is how vulnerable everything is because you're going into people's homes and they're in crisis.” “I think Rob, no one should be allowed to graduate from high school without their kind of basic CPR training.” “Everything about EMS — the tone, the vibe, the gallows humor, certainly all the technical medical elements, the burnout, the camaraderie, the idea that there's a mission here — they do it because they love it.” “Well, it was an honor to learn about this world and to make a movie that these workers are excited about and proud of.” “I want to say from the bottom of my heart, you know, ‘thank you. Thank you for your work. And, you know, I think it's grossly underappreciated, but, you know, America needs you.’” Episode timeline 00:26 – Rainn Wilson on the vulnerability of entering people’s homes in crisis 00:57 – “All we want to do is save your life. Some of you don’t make it easy.” 02:53 – Rainn’s first impressions of the “Code 3” script 03:38 – Falling in love with the character of Randy 04:22 – Discovering the realities of EMS work and shocking pay disparities 06:09 – Lessons from Wilson’s Los Angeles ride-along 10:12 – Wilson on CPR training and why everyone should learn it 12:29 – “We’re essentially a tube and a pump.” 13:11 – Rehearsals and the importance of portraying EMS medicine accurately 15:09 – On burnout, PTSD and the need to support medics’ mental health 18:08 – Using “Code 3” salary comparison as an advocacy tool 19:07 – Wilson praises Rob Riggle’s ED doctor role and its realism 20:41 – Cherishing the chance to shed light on EMS 21:10 – Reminder that the film is also a comedy — “a good old time with a bucket of popcorn” 22:25 – Final message: “America needs you. Keep saving lives.” Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Patrick Pianezza, co-writer of the new EMS film “Code 3”, a deeply honest and compelling portrayal of life on the ambulance. The film stars Rainn Wilson (“The Office”), Lil Rel Howery (“Free Guy”) and Aimee Carrero (“Elena of Avalor”), delivering a powerful performance that captures both the pressures and the humanity of EMS work. Using real-world experiences and stories from the field, “Code 3” highlights the passion, dedication and emotional toll experienced by EMS professionals every day. From burnout, to systemic challenges, the movie invites the public into the high-stakes world of emergency medical services, showing both the challenges and the heart behind the uniform. Patrick and Rob discuss not only the storytelling process, but also the personal experiences that informed the movie. Pianezza candidly shares the emotional toll of EMS work, the reality of burnout and the importance of mental health support for first responders. This episode is both a celebration of the dedication of those who serve in 911 and a call for awareness and gratitude for the vital work they perform. “Code 3” opens in selected cinemas on Sept. 12, 2025. Memorable quotes “I remember going to one of my old bosses and saying, ‘I think I'm burning out.’ The reaction I got was this dark chuckle … ‘We're all burnt out. Get back on the truck.’ That kind of festering mentality is not healthy.” — Patrick Pianezza “Six out of six people that I have worked with have unfortunately [died by] suicide, and the suicide rates for first responders is double that of the regular population … which is a statistic we need to fix.” — Patrick Pianezza “And it is … a good representation of life on the truck, on the street, with a guy who’s clearly burned out; but a person that cares, that has passion, commitment and will always do the right thing.” — Patrick Pianezza “There was no way to confront the story without talking about salaries, without talking about reimbursements … No one's gonna see a movie about Medicare, Medicaid, but we are as honest as we can be.” — Patrick Pianezza “This movie is nothing more than a gratitude tour for everyone who works in 911 … I’ll be a broken record here: thank you for what it is that you do because it matters. I’ve been in those boots and I’m here to tell you thank you.” — Patrick Pianezza “And as I say in my review, those who know me know my ability to take tactical naps during movies. Well, this one got two eyes open and absolutely five stars.” — Rob Lawrence Episode timeline 00:00 – Introduction: Rob Lawrence introduces Patrick Pianezza and the film “Code 3” starring Rainn Wilson 02:31 – Origins of “Code 3:” How the project started and the vision behind telling an authentic EMS story 05:01 – Creative team & casting: working with actors, crew and Rainn Wilson 08:01 – On-the-Street authenticity: translating real EMS experiences into the film 12:01 – Depicting burnout: emotional and mental challenges in EMS work 16:01 – Mental health & seeking help: Autobiographical elements and confronting burnout 20:01 – Systemic issues: salaries, Medicare, and Medicaid reimbursement challenges 24:01 – Impact on families & relationships: emotional toll beyond the job 27:01 – Personal reflection: Patrick’s journey, struggles and growth in EMS 29:01 – Gratitude tour: purpose of the film and acknowledging EMS professionals 32:01 – Closing thoughts: film release details, upcoming trailer and final messages of appreciation Enjoying the show? Send an email to editor@ems1.com to share feedback or suggest guests for upcoming episodes. 

This breaking-news edition of EMS One-Stop dives straight into the announcement that the National EMS Advisory Council (NEMSAC) has been dissolved. Host Rob Lawrence is joined by Dr. Brandon Morshedi (NEMSAC chair-elect) and Brenden Hayden (immediate past chair), who explain what NEMSAC is, what it achieved and why its sudden dismissal has left the EMS community frustrated, concerned and searching for answers. Together, they outline the role of NEMSAC as the sole statutory advisory body connecting EMS to the federal executive branch, describe the hundreds of volunteer hours that went into shaping advisories, and discuss what happens now that years of hard work and documents have been pulled from EMS.gov. This episode sets the record straight, provides a clear explainer of the process, and captures the disappointment — yet determination — of leaders committed to moving EMS forward despite this setback. Additional resources: How NEMSAC is composed — who sits on the council and what types of expertise are represented The NEMSAC’s statutory role advice/briefings at the federal level NEMSAC’s key accomplishments Episode timeline 01:08 – Rob introduces the breaking news: NEMSAC dissolved 02:22 – What is NEMSAC? Brenden explains its statutory role 04:52 – How does NEMSAC differ from associations? Direct advisory to the executive branch 06:42 – Appointments, terms and how continuity usually worked 08:44 – The depth of work: meetings, subcommittees, advisories, letters 11:23 – Examples of major advisories and public comment process 14:27 – Shock: key advisories removed from EMS.gov 19:13 – Explainer: FICEMS and how advisories flow through federal government 26:25 – How members felt when dismissal was announced 30:18 – What happens to unfinished advisories and research 34:20 – Associations’ role in keeping the work alive 35:50 – The advisory each guest is most proud of 39:41 – Lessons learned: influence, unified voice, process 43:25 – Final reflections: leadership, advocacy, and what comes next Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

In this episode of the EMS One-Stop podcast, host Rob Lawrence climbs back onto his soapbox to discuss two topics that directly impact on every EMS agency in America — the CAAS Ground Vehicle Standards (GVS) 4.0 and the simple, inexpensive steps we can take to stop ambulance theft. Joining Rob is longtime EMS leader and current CAAS GVS Administrator Mark Postma, who walks us through the origins of the standards, their national adoption and what’s new in the latest update. From ambulance remounting, to structural safety testing, Mark explains how GVS 4.0 has evolved to keep pace with manufacturing realities, supply chain delays and operational needs. The conversation then shifts to a shared passion for protecting fleet assets. Rob and Mark dissect the shockingly frequent problem of ambulance theft and how a $200 automatic immobilization device can prevent a $250,000 vehicle from disappearing — without relying on crews to remember to lock it. Additional resources: CAAS GVS V4.0 – Ground Vehicle Standard Commission on Accreditation of Ambulance Services (CAAS) – The New Standard in Mobile Healthcare Ambulance thefts in the U.S. surge: Over 40 stolen rigs in 18 months 6 ways to safety-proof your EMS fleet Memorable quotes "It’s no good going to City Council or to your board of directors on day 365 and saying, ‘I need a new truck for New Year day one’ — that’s not going to happen." — Rob Lawrence "The ground vehicle standard has become the standard that most vehicles are being built to and that state EMS officials are using." — Mark Postma "We spend a lot of time thinking about where things go in the box … add one more thing to your checklist: can the vehicle indeed be immobilized?" — Rob Lawrence "There’s just no reason why ambulances are being stolen with the current technology that’s out there." — Mark Postma Episode timeline 00:45 – Rob introduces the topic: GVS 4.0 and ambulance theft concerns 01:34 – Mark introduction and CAAS GVS role 04:11 – How the CAAS standards were developed and adopted by 35-plus states 06:09 – Comparing CAAS GVS to NFPA ambulance standards 06:48 – The rise of remounting, especially during COVID supply shortages 10:26 – Discussion of ongoing vehicle delivery delays and need for replacement planning 15:04 – What’s new in GVS 4.0 — major changes and safety structure updates 19:38 – Ambulance theft statistics and the GVS anti-theft requirement 22:28 – Automatic immobilization and why manual systems fail 23:57 – Mark shares success story: zero thefts since installing devices 26:17 – Exceptions in standards and why state inspectors must enforce anti-theft 27:42 – Final thoughts on making anti-theft part of fleet planning Enjoying the show? Email editor@ems1.com to share feedback and suggest future guests. 

In this edition of the EMS One-Stop podcast, host Rob Lawrence Zooms (literally) from the U.K. to South Carolina to spotlight one of the nation’s most forward-thinking mobile integrated healthcare programs. Prisma Health’s team has taken community paramedicine beyond buzzwords, designing targeted, evidence-based programs that meet people where they are — both geographically and medically. | MORE: How North Dakota EMS is confronting rising pediatric mental health crises  Whether it's addiction medicine, rural HIV/HCV treatment or skilled nursing interventions, this team is shifting paradigms on what EMS can and should be doing. Rob is joined by four key voices from the Prisma Health MIH program: Luke Estes, director of MIH Dr. Mirinda Gormley, epidemiologist and biostatistician Wes Wampler, community paramedic specializing in addiction and infectious disease Parker Bailes, community paramedic and research contributor Together, they unpack how passion meets data to drive change, how to earn trust in communities overlooked by traditional systems, and why this work isn’t just novel — it’s necessary. This is EMS in its truest public health form. Memorable quotes “You delivered the goods—data-driven, community-connected care — and that’s what EMS in 2025 needs more of.” — Rob Lawrence “When you see some of your people who have a passion for a certain pathway in EMS, you try to give them the reins and say, you're gonna do some good.” — Luke Estes “One of the big things that we learned from his study was that we really needed to go out and make sure everybody was aware that addiction is a disease.” — Mirinda Gormley “If we can gain their trust, there’s a lot more that we can kind of weasel our way into to help them solve and get them on a healthier trajectory.” — Wes Wampler “Walking into the (care) facility with the mindset of, ‘I'm going to do everything I can to keep you here,’ was a big shift for me.” — Parker Bailes “If we can set them up to be successful after they leave the hospital, I think that's the best way to get them reengaged with the hospital.” — Wes Wampler “As their leader … all I have to say is, what do you need? I'm here to support you.” — Luke Estes Additional resources EMS Clinician Perceptions on Prehospital Buprenorphine Administration Programs: Prehospital Emergency Care: Vol 29 , No 4 Implementation Barriers of Prehospital Buprenorphine Administration Programs in the United States: A Scoping Review: Prehospital Emergency Care: Vol 29 , No 4 Using Community Paramedicine to Treat Hepatitis C Virus in Upstate South Carolina - PMC Luke Estes BA, NRP, CCEMTP, PNCCT, FP-C, CP-C | LinkedIn Wesley Wampler | LinkedIn Support for harm reduction by community EMS How does a community re-imagine compassion to avoid crisis whenever possible? Breaking barriers: Hennepin EMS leads the way in safely implementing buprenorphine Episode timeline 00:51 ­– Introduction to Prisma Health MIH & guests 03:00 – Luke Estes overview of MIH models (ETS, SDOH, addiction) 05:00 – Dr. Gormley’s public health journey, data-opioid focus 08:00 – Buprenorphine pilot design and research outcomes 10:15 – Challenges: bias, stigma, barriers to addiction care 13:00 – Funding and sustainability conversation 14:00 – Wes Wampler on daily workflow in addiction medicine and HCV care 17:00 – Building trust with vulnerable populations 18:30 – Parker Bailes discusses traditional CP role and skilled nursing interventions 21:45 – Alternative destinations, lab draws and high-acuity decisions 25:30 – Training: internal education, ultrasound, medication management 28:15 – Prisma’s med school connection and disaster response evolution 30:00 – State-level partnerships: SC EMS Assn, FEMA typing, CP strike teams 31:56 – Academic next steps from Dr. Gormley: scaling, publishing, process evals 35:26 – Final reflections from Luke Estes: passion, team strength and mission 38:00 – Rob’s call to action: “If you want your own Prisma team — start now.” Enjoying the show? Email editor@ems1.com to share feedback or suggest future guests. 

In this high-impact edition of the EMS One-Stop podcast, host Rob Lawrence sits down with EMS influencer and educator Jimmy Apple, known widely across platforms as The EMS Avenger. With nearly 70,000 followers on TikTok and a growing presence on Instagram and Facebook, Jimmy has mastered the art of compressing complex clinical topics into digestible, engaging content. | More: What the EMS Counts Act means for dual-role EMS providers  In this conversation, Rob pulls back the curtain on the man behind the mobile screen — exploring Jimmy's journey from electrician to pediatric critical care paramedic, and now, one of EMS's most watched and listened-to voices. Listeners will gain deep insight into Jimmy’s origin story, his social media strategies, his refusal to let bad information go unchallenged, and his passionate belief that “Saving lives begins with kindness.” The pair also tackle: Content creation advice for EMS agencies The challenges of tone and accuracy in short-form video How to maintain compassion in the face of a toxic work culture This episode is part masterclass in communication, part call to action for the future of EMS — and all heart. Memorable quotes from Jimmy Apple: The EMS Avenger “Saving lives begins with kindness. That is my motto, it is my philosophy.” “You have to package something down to its bare essence … there's some nuance lost, but you have seconds to keep people's attention.” “My goals going forward are to support people who are acting in good faith while correcting the misinformation.” “Generally speaking, you will draw the engagement that you're looking for. If you're putting out content in good faith, you'll get good faith engagement.” “We are responsible for ourselves and how we respond … and I believe we need to respond to everything that is happening in the world today with kindness.” Episode timeline 00:54 – Rob introduces Jimmy Apple, aka the EMS Avenger 01:20 – Jimmy’s background: from electrician to EMS 03:30 – The grandfather conversation that changed his life 04:50 – How pathophysiology sparked a love for learning 05:40 – Birth of the EMS Avenger: from student favorite to TikTok influencer 06:55 – Ginger Locke’s advice that redirected Jimmy’s podcast path 08:04 – Compressing content: "from textbook to bumper sticker" 10:00 – The content hook: “Are we getting rid of normal saline?” 11:00 – How Jimmy selects topics: research, news, curiosity and requests 13:00 – Hot topics in EMS: cricothyrotomy, TXA, ketamine, provider safety 14:40 – Rob discusses EMSIntel.org and ambulance theft data 16:00 – Can EMS agencies do what Jimmy does? The risks and the realities 18:30 – "Stop the finger": creating content that captures attention 20:00 – Rob on the risks of public messaging and backlash 21:00 – Calling out misinformation: the line between education and shame 23:00 – Jimmy’s growing reach across TikTok, Instagram and Facebook 24:45 – Managing Facebook’s deeper comments and nuanced conversations 26:45 – Jimmy’s rule: “Engage only with good faith” 27:50 – Final thought: EMS must rediscover kindness 29:00 – Closing remarks and where to follow Jimmy Apple online Additional resources Connect with Jimmy Apple, better known as The EMS Avenger: TikTok — Jimmy offers short-form, evidence-based EMS content here: @emsavenger Instagram — Engage with in-depth reels, visuals, and professional updates: @emsavenger X (formerly Twitter) — Follow EMS commentary, conversation, and boosts: @EMSAvenger Facebook — Join the group for discussions and shared insights: EMS Avenger community Apple Podcasts — Listen to “EMS Avenger: 20 Minutes to Save the World”: Weekly podcast series AAA & AIMHI EMS Media Log: EMS Intel Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.